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BlueCare Plus Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for BlueCare Plus Select (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on BlueCare Plus Select (HMO D-SNP) in 2025, please refer to our full plan details page.
BlueCare Plus Select (HMO D-SNP) is a HMO D-SNP plan offered by BlueCross BlueShield of Tennessee available for enrollment in 2025 to people living in Tennessee. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that BlueCare Plus Select (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
BlueCare Plus Select (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about BlueCare Plus Select (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For BlueCare Plus Select (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $40.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9350.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The BlueCare Plus Select (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs for your drugs based on the drug tier. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs. If you qualify for the low-income subsidy, you'll pay $40.00.
Additional Benefits
The BlueCare Plus Select (HMO D-SNP) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a high copay, while many outpatient services, including primary care, hearing, vision, and dental, have a 20% coinsurance. The plan also includes coverage for ambulance services, with a 20% coinsurance, and offers transportation services up to a monthly limit. This plan covers several services with no copay, such as Emergency Services, preventive services, home health services, and Durable Medical Equipment (DME). However, it's important to note that some services, like inpatient psychiatric care and skilled nursing facilities, have specific cost-sharing structures. Additionally, some services require prior authorization, and there are limitations on coverage for certain services like hearing aids and eyewear.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, each with a copay of $1940 for a Medicare-covered stay. Additional Days, Non-Medicare-covered stays, and Upgrades for Inpatient Hospital-Acute and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, as well as Ambulatory Surgical Center (ASC) Services and Outpatient Substance Abuse Services, both with a 20% coinsurance. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will pay 20% coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services. Transportation Services to plan-approved health-related locations are covered, with a maximum plan benefit coverage amount of $275.00 every month, and transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services are covered by the BlueCare Plus Select (HMO D-SNP) plan with a 20% coinsurance, but no copay. Urgently Needed Services are also covered with a 20% coinsurance and no copay. Worldwide Emergency Services, including coverage, urgent care, and transportation, are not covered.
Primary Care See details
The BlueCare Plus Select (HMO D-SNP) plan covers Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits and Opioid Treatment Program Services. Primary Care Physician Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have a 20% coinsurance. Chiropractic Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have a 20% coinsurance. Occupational Therapy Services, Individual and Group Sessions for Mental Health and Psychiatric Services have a coinsurance of 20%.
Preventive Services See details
Preventive Services are covered, but annual physical exams, in-home safety assessments, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, home and bathroom safety devices and modifications, and counseling services are not covered. Medicare-covered Zero Dollar Preventive Services are covered with no copay, and additional services like health education, personal emergency response systems, fitness benefit (memory fitness), telemonitoring services, remote access technologies, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit are covered with 20% coinsurance.
Hearing Services See details
Hearing services include hearing exams, with a coinsurance of at most 20% for routine hearing exams, and fitting/evaluation for hearing aids. Prescription hearing aids are partially covered, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams and eyewear benefits. Routine eye exams and eyewear, including contact lenses, have a 20% coinsurance, with a combined maximum of $500 per year for all eyewear. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are partially covered by the BlueCare Plus Select (HMO D-SNP) plan, with Medicare Dental Services being covered but services such as Orthodontic Services, Restorative Services, and others not covered. This plan does not specify any cost information for the covered dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Insulin and Other Medicare Part B Drugs, with a copay of $35 for Medicare Part B Insulin Drugs and a coinsurance between 0% and 20% for all services. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the BlueCare Plus Select (HMO D-SNP) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered under the BlueCare Plus Select (HMO D-SNP) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, and Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance; there is no copay for any of these services. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the BlueCare Plus Select (HMO D-SNP) plan, with a coinsurance of at most 20% for Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services; there is no copay for these services.
Home Health Services See details
Home Health Services are covered under the BlueCare Plus Select (HMO D-SNP) plan with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the BlueCare Plus Select (HMO D-SNP) plan. Some services that fall under Cardiac Rehabilitation Services include Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services, but none of these services are covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the BlueCare Plus Select (HMO D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered, and non-Medicare-covered stays, are not covered.
Other Services See details
Other Services are partially covered by the BlueCare Plus Select (HMO D-SNP) plan; however, acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. The plan does offer a meal benefit for chronic illnesses, with no maximum benefit coverage amount.
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